autism spectrum disorders gill capaldi

8/10/2019 Autism Spectrum Disorders Gill Capaldi

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Autism Spectrum Disorders

An introduction to ASD including a

brief history, profile, implicationsand opportunity for discussion


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Autism Spectrum Disorder

Developmental disorder affecting children from birth orthe early months of life.

Exact cause remains unknown, but generally felt to beneurological in origin, although recent research points topossible genetic or chromosomal abnormalities as wellas viral infections, pregnancy/birth complications and/orother causes.

May co-exist with other medical conditions e.g. fragile Xsyndrome, tuberous sclerosis.

Often accompanied by additional learning difficulties(about 75%).

No single consistent explanation at the moment.


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Background / History

Leo Kanner (USA) Child Psychiatrist

Paper published in 1943 based on study of 11 cases.

Resulted in identification of a separate condition

Autism.

He wandered about smiling, making stereotyped movements with his

fingers, crossing them about in the air. He shook his head from side to

side...humming the same three-note tune. He spun with great pleasure

anything he could seize upon to spin.When taken into a room, he

completely disregarded the people and instantly went for objects,

preferably those that could be spun.( Kanner 1943)


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Hans Asperger (Austria) Physician

Identified similar group.

1944 published dissertation on autistic

psychopathy in childhood

Published in German and in middle of Second

World War - it took nearly 50 years before it was

translated (Wing 1981)

Many similarities with Kanner use of autistic


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Lorna Wing research with Judy Gould (1979)

Identified threads of commonality

amongst group of children referred for

psychiatric help who were socially impaired.

Wings Triad of Impairments

1988 The Autistic Continuum

1996 The Autistic Spectrum broader classification


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Triad of Impairments

Social

Relationships

Social

Communication

Rigidity of Thought,Behaviour and Play

(Social Understanding)

ASD


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Communication

Some children may not use spoken language to

communicate, and may use non-verbal means instead,e.g. pushing, biting, squealing, crying

Even children with developmentally appropriate verbalskills may have problems with their useof languagewhen talking to others (pragmatics). They may have

difficulties with their non-verbal communication as well. May not understand subtle conversational clues e.g.

facial expressions indicating surprise, anger etc. andmay therefore not know to look contrite.

May have difficulties with concepts e.g. more / less, time

(including the need to wait) Inability to ask questions to establish another persons

view point, but may ask repetitive questions e.g. What'syour name? This may mask unspoken anxieties in thechild or indicate that they have not understood.


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Communication

Some children may use unusual intonation withstereotypical, stilted speech (or a sing-song intonationpattern)

May have a very literal understanding of speech -therefore may fail to follow a lot of classroom languagee.g. "its time to go outside" may mean take your apronoff, get your coat and line up at the door" but a child with

ASD may think they can go straight outside and mayconsequently appear disobedient. Literality can lead to

distress e.g. go to the toilet and wash your hands" Repetition of chunks of language heard in other

situations/videos - may sound clumsy or odd


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Social Relationships Child may display general awkwardness in social

situations

May be unable to interact appropriately with peers

Difficulty in making friends may initiate and want

social contact, but lack understanding and skills to

carry through

Unusual facial and/or physical gestures (smiles,

grimaces, eye-contact)


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Social Relationships Problems with social distance

Child may have difficulties with conventional

turn-taking and sharing. May start/finish

conversations abruptly or fail to answerappropriately.

Child may not see themselves as a part of group

Motivation may not be rewarded by success at

tasks(They are not being lazy or obstinate!)


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Rigidity of thought, play and behaviour

Their play may be learnt and repeated. This means thatinitially the childs play skills may appear appropriate, butover time it is apparent that the childs play sequencesare not extending.

Imaginative and symbolic play begins to emerge at

around 2 to 2 years, but for children with ASD theirplay may be repetitive and limited to specific actions, e.g.lining toys up, moving trains around a track

May find activities difficult when imagination or pretendskills are needed, e.g. home corner, role play games

Difficulty coping with adult direction and imposedroutines

Difficulties with understanding changes in routine andnew situations


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Rigidity of thought, play and behaviour

Some children exhibit fixed interests and maybecome obsessional about these

Attentional problems on tasks chosen by others

Difficulties with problem solving, e.g. finding an

item that is not in its usual place Seeing 'part' rather than 'whole' - not the 'bigger

picture, e.g. focusing on a specific part of apicture

Rigidity of thinking and behaviourbeing aclass policeman

Perseveration - the need to repeat words,actions, activities etc


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Beyond the Triad of Impairments

The Sensory World of Autism

Senses provide us with the unique experiences which

allow us to interact & be involved with others

Senses play a significant role in determining ourresponses to a particular situation

Many individuals with autism experience either an

intensification or absence of sensory integration

Hyper Hypo


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The Sensory World of utism

The Five Senses

Touch (includes balance and body awareness)

Tactile: relates to touch ,pressure, pain, hot/cold

Hypo- Holding others tightly

(Social aspect)Sensitivity to certain clothing/textures

High pain threshold

Self-harming (biting, gouging etc.)

Hyper- Finds touch painful/uncomfortable

Dislike of having things on hands/feet


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The Five Senses

Touch (includes balanceand body awareness)

Vestibular: informs where body is in space

Hypo- The need for rocking, swinging,spinning

Hyper- Difficulties in activities which include

movement (sport, dance)Difficulties in stopping quickly or during an

activity


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The Five Senses

Touch (includes balance and body awareness)

Proprioception: where how body is moving

Hypo- Proximitypersonal body space in relation toothers.

Navigating roomsavoiding obstructions.

Hyper- Fine motor difficulties, manipulating smallobjects (buttons, threading, shoe laces etc).

Moves whole body to look at something.


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The Five Senses

Sight

Visual: helps to define objects, colours, space

Hypo- Peripheral vision (central vision blurred)Poor depth perception (throwing/catching)

Hyper-Fragmentation of images (too many sources)Focussing on particular detail (rather than

whole).


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The Five Senses

Hearing

Auditory: informs about sounds around us

Hypo- Partial or complete absence of hearingEnjoys noisy places/activities (bangs things)

Hyper- Magnification or distortion of sounds

Unable to filter out external sounds


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The Five Senses

Smell

Olfactory: Is the first sense we rely on

Hypo- May be oblivious to strong odoursMay lick things indiscriminately

Hyper- Smells appear intensified/overpowering.

Toileting problems


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The Five Senses

Taste

Gustatory: Informs about various tastes

Hypo- Likes very spicy/salted foodsMay eat anything (soil, grass, material etc)

Hyper- Prefers bland (white) food

Texture of food may be problematic (lumps)


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The National Picture

Estimated population of ASD (whole

spectrum) in the UK

National Autistic Society estimated the

prevalence at 1:100

No. of children with ASDs under 18 (est.)

133,500(based on 2001 censusUK under-18

population of 13,354,297


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The Local Picture

October 2006Yorks & Humbs ASD

Regional Partnership Benchmarking

questionnaire. Numbers of pupils in each

regional Local Authority with ASDs.

Mainstream & Special School pupils from

pre-school to Post 16

Rotherham incidence: slightly higher

(approx 650 children with diagnosed ASDs


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Discussion Points

Implications for education

Implications for families

Support networks (schools) Support networks (families)

Any other questions?

autism spectrum disorders gill capaldi

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